MEDICARE: VALLEY WOUND SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1598656381
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY WOUND SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	2210 SAWTOOTH MOUNTAIN DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89044-0108
Country	:	US
Telephone Number	:	725-777-6566
Fax Number	:

Provider Business Practice Location Address
First Line	:	2210 SAWTOOTH MOUNTAIN DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89044-0108
Country	:	US
Telephone Number	:	725-777-6566
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	IKE MENDOZA
Credential	:	APRN, FNP-C
Telephone Number	:	725-777-6566

Provider Enumeration Date	:	07/10/2025
Last Update Date	:	07/10/2025

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Directions to “VALLEY WOUND SOLUTIONS LLC ” Practice Location

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